ELDirect In-Home Elderly Care ELDerGrant application

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Since 1996 we have always gone the extra mile to provide exceptional care for our Clients. Starting ELDirect from our own family caregiving experiences we understand the financial burden that paying for in-home care can bring to families. To help give back to the communities that have supported us through the years we now offer free in-home care each week to needy individuals through our ELDerGrant program.

The ELDerGrant program is designed to provide in-home care services to those in need in the NW Arkansas and Ft. Smith/River Valley regions. The ELDerGrant program is designed to provide short-term services to individuals who cannot afford or qualify for in-home care. We select 2 individuals in each region every 2 weeks for services. Again, our targets are the neediest individuals that cannot afford or don’t qualify for in-home care. We have created a simple application that will allow you to help your patients, friends or customers apply.

Date: __________________________________________

Applicant name (person needing care), age, address, phone number, contact and primary contact information:

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Your name (person completing the application):

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Your relation to the Applicant:

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Your contact information: Business name, address, city, zip, phone and email.

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Why is the Applicant unable to attend to their daily living needs without the assistance of a caregiver? Explain.

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What services does the Applicant need assistance with?

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Does the Applicant qualify for alternative funding for in-home care such as ElderChoices, Veterans Administration, long-term care insurance, Alternatives for Aging, or other? If unknown, call ELDirect for pay source qualification criteria.

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Applications must be received by the 15th of each month to qualify for the following month’s ELDerGrant. Applicants must show proof of current financial resources, income, insurance, etc. Applications may take 2 or more weeks to process.

Mail or drop-off applications to:
ELDirect
2662 E. Joyce Blvd #2
Fayetteville, AR 72703

ELDirect
3101 Free Ferry, Suite G
Ft. Smith, AR 72903

Fax applications, attention Candra Davis, to:
479-443-0183 for Benton, Washington County and Ft. Smith/River Valley area applicants
Email applications to:CandraDavis@ELDirectHomecare.com

Scope of coverage
The ELDerGrant program does NOT provide skilled services. Completing and submitting the ELDerGrant application does not guarantee approval for ELDerGrant services. Services consist of non-medical in-home care such as light homemaker duties, guidance and monitoring of daily living skills, companionship and respite services for family caregivers. Call ELDirect for a complete list of services.

Benton County – 479-621-8184 * Ft. Smith/River Valley areas – 479-709-9005
Washington County – 479-443-7173
www. ELDirectHomecare.com

NW Arkansas

Ft. Smith/River Valley

Contact Us:

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Feel free to copy, save and print the ELDerGrant application

LeighDavis@ELDirectHomecare.com